JACKIE PETERSON LICSW, LCSW
NPI 1932685252
Counselor - Mental Health in Boston, MA

Q: What is Jackie Peterson's NPI number?

The NPI number for Jackie Peterson is 1932685252. It was assigned to this individual provider in the NPPES registry on July 19, 2018.

Q: What is Jackie Peterson's specialty?

The primary specialty registered for this NPI is Counselor, specializing in Mental Health, with taxonomy code 101YM0800X.

Q: When was this NPI record last updated?

The NPPES record for Jackie Peterson was last updated on October 27, 2022. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 3 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.

Active since July 19, 2018

399 BOYLSTON ST, BOSTON, MA 02116(617) 336-3246 Get Directions Write a Review

NPPES record last updated: October 27, 2022. Verified against the NPPES registry weekly; last sync: August 02, 2026.

Record update history: Oct 27, 2022, Dec 1, 2020, Jul 19, 2018 (3 updates tracked since 2018).

On this page

About Jackie Peterson Licsw, Lcsw NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

JACKIE PETERSON LICSW, LCSW (NPI 1932685252) is an individual mental health provider in Boston, Massachusetts and active in the NPI registry since July 2018. She maintains a secondary practice location in Worcester.

NPPES Registry Identity

NPI1932685252

Entity TypeIndividualFemale

Primary Taxonomy101YM0800X

Provider Legal NameJACKIE PETERSONCredential: LICSW, LCSW

Location Address399 BOYLSTON STBoston, MA 02116-3305

Mailing Address43 Harrison AveWallingford, CT 06492-5003 · (203) 350-9565

Phone(617) 336-3246

Sole ProprietorYes

Enumeration DateJuly 19, 2018

Last NPPES UpdateOctober 27, 20223 updates tracked since enumeration

NPPES CertifiedOctober 27, 2022

✔ NPI 1932685252 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 2

★ Primary SpecialtyCounselor · Mental HealthBehavioral Health & Social Service Providers

Taxonomy Code101YM0800X

Also ListedCounselor · Addiction (Substance Use Disorder)Taxonomy 101YA0400X

399 BOYLSTON ST, Boston, MA 02116

Open in Google Maps ↗

Secondary Practice Location 1

Location 1585 Lincoln StWorcester, MA 01605-1906 · Phone (508) 831-0045 · Fax (508) 856-7390

Other Providers at the Same Location NPPES 3

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

CARBON HEALTH MEDICAL GROUP OF FLORIDA PA

Clinic/Center (Urgent Care)

399 BOYLSTON ST
BOSTON, MA 02116

Suffolk County (857) 384-6986

VLADIMIR ODINETS PA-C

Physician Assistant (Medical)

399 BOYLSTON ST
BOSTON, MA 02116

Suffolk County (857) 416-9218

KATHERINE I ZOMBIK

Physician Assistant

399 BOYLSTON ST
BOSTON, MA 02116

Suffolk County (857) 384-6986

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Jackie Peterson's NPI number?

The NPI number for Jackie Peterson is 1932685252. It was assigned to this individual provider in the NPPES registry on July 19, 2018.

Where is Jackie Peterson located?

Jackie Peterson practices at 399 Boylston St, Boston, MA 02116. The listed phone number is (617) 336-3246.

What is Jackie Peterson's specialty?

The primary specialty registered for this NPI is Counselor, specializing in Mental Health, with taxonomy code 101YM0800X.

When was this NPI record last updated?

The NPPES record for Jackie Peterson was last updated on October 27, 2022. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 3 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.